Assessing gender bias in qualitative evaluations of surgical residents

Background: There are notable disparities in the training, recruitment, promotion, and evaluation of men and women in surgery. The qualitative assessment of surgical residents may be implicitly gender biased. Methods: We used inductive analysis to identify themes in written evaluations of residents. We also performed a content analysis of words fitting previously defined communal, grindstone, ability, and standout categories. Results: Differences in themes that emerged from evaluations of male and female residents were notable regarding overall performance, references to the future, professional competency, job domains, disposition and humanism, and overall tone of evaluations. Comments about men were more positive than those about women, and evaluations of men included more standout words. Conclusions: The more positive evaluations of men may handicap women if they are seen as less likely to perform well based on these evaluations. These differences suggest that implicit bias may play a role in the qualitative evaluation of surgical residents.